19D2178031 CLIA NUMBER - BROKEN WINGS RECOVERY CENTER

Laboratory Demographics

  • CLIA Code: 19D2178031
  • Facility Name: BROKEN WINGS RECOVERY CENTER
  • Facility Address: 2869 NEW MONROE RD
    BASTROP, LA
    ZIP 71220
  • Facility Phone: 318 558-0500
  • Facility Type: Other - SUBSTANCE ABUSE - ADULTS
  • Facility Type: Waiver
  • Lab Director: REBECCA S. PARKS
  • NPI Number: 1952935983
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 19D2178031
LAB Type Other - SUBSTANCE ABUSE - ADULTS
Facility Name BROKEN WINGS RECOVERY CENTER
Street 2869 NEW MONROE RD
City BASTROP
State LA
ZIP 71220
Phone 318 558-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Other - SUBSTANCE ABUSE - ADULTS
Lab Director REBECCA S. PARKS

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This page was last updated on: 9/29/2025